Individual
AIDA MARINA LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
12550 BISCAYNE BLVD STE 308, NORTH MIAMI, FL 33181-2537
(305) 893-1830
(305) 893-0395
Mailing address
12550 BISCAYNE BLVD STE 308, NORTH MIAMI, FL 33181-2537
(305) 893-1830
(305) 893-0395
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
DN1409
FL
1223G0001X
General Practice Dentistry
Primary
DN1409
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1851492797
PPO DENTAL INSURANCES
FL
Enumeration date
07/09/2014
Last updated
07/09/2014
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